The key finding of the study was that parental preferences in the hypothetical phase of the study strongly corresponded to decisions about pain management in the clinical phase of the study. “We looked at three side effects. We used nausea and vomiting because they are most common, and sedation because it is the most serious. We looked at three decision-making situations: pain without side effects, pain with nausea and vomiting, and pain with sedation,” said Voepel-Lewis, lead author of the study.

The study found that parents who had a higher preference to provide pain relief were less likely to withhold pain relief if there were side effects. “About 19 to 20 percent of parents with a strong preference for pain relief overtreated. Parents who had a preference toward risk avoidance, tended to make the right treatment decision in the presence of side effects but also tended to require a higher pain score before treating pain without side effects,” says Voepel-Lewis. [2] Parents used the 1-10 FACES pain scale (FPS). Most parents would treat a pain score of 4 to 6.1 “Risk averse parents required a higher PFS score of 7 or 8 to initiate treatment,” said Voepel-Lewis.

Key Takeaways

“All parents want their child to be pain free after surgery without any complications. But there are always trade-offs. It all boils down to which is more tolerable – pain or side effects. This study reminds us that preferences are value judgments, and they can drive decision making more than facts,” said Brian Zikmund-Fisher, PhD, associate professor of health behavior at the School of Public Health at the University of Michigan Medical School, coauthor of the study.